MR. LOGAN NIELSON PA-C
NPI 1184199648
Physician Assistant - Medical in Burley, ID

Q: What is Logan Nielson's NPI number?

The NPI number for Logan Nielson is 1184199648. It was assigned to this individual provider in the NPPES registry on October 10, 2018.

Q: What is Logan Nielson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Logan Nielson was last updated on October 10, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 10, 2018PECOS EnrolledAccepts Medicare Assignment

382 N OVERLAND AVE, BURLEY, ID 83318(208) 678-6996 Get Directions Write a Review

NPPES record last updated: October 10, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mr. Logan Nielson Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. LOGAN NIELSON PA-C (NPI 1184199648) is an individual medical provider in Burley, Idaho and active in the NPI registry since October 2018. He is enrolled in Medicare PECOS, is affiliated with Lost Rivers Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1184199648

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameMR. LOGAN NIELSONCredential: PA-C

Location Address382 N OVERLAND AVEBurley, ID 83318-3433

Mailing Address300 Dennis DrBurley, ID 83318-3217

Phone(208) 678-6996

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateOctober 10, 2018

✔ NPI 1184199648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

382 N OVERLAND AVE, Burley, ID 83318

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Secondary Practice Locations 2

Location 12392 Addison Ave ETwin Falls, ID 83301-6745 · Phone (208) 933-4440

Location 2133 W Avenue AJerome, ID 83338-2630 · Phone (208) 324-2004

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Logan Nielson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517206816

PECOS Enrollment IDI20190305000284

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

89 services63 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

15 services15 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lost Rivers Medical Center

Critical Access Hospitals · Arco, ID

OwnershipGovernment - Hospital District or Authority

CMS Certification Number131324

Location551 Highland DriveArco, ID 83213 · Butte County

Emergency services

Cassia Regional Hospital

Critical Access Hospitals · Burley, ID

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number131326

Location1501 Hiland AvenueBurley, ID 83318 · Cassia County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACOB WALKER PA-C

Physician Assistant (Medical)